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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153907476
Report Date: 11/23/2021
Date Signed: 11/23/2021 02:40:49 PM

Document Has Been Signed on 11/23/2021 02:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CALLAHAN, KEYA FAMILY CHILD CAREFACILITY NUMBER:
153907476
ADMINISTRATOR:CALLAHAN, KEYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 900-3027
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
11/23/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Keya CallahanTIME COMPLETED:
03:00 PM
NARRATIVE
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On 11/23/2021, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced annual inspection and met with Licensee, Keya Callahan. Also present was assistant Elizabeth Callahan. A tour of the home was conducted, and a census was taken. Current facility sketch reviewed, and Licensee confirmed the living room, dining area, kitchen, the play room, hall bathroom and the enclosed porch are used for providing care and are accessible to day care children. All other rooms are off-limits and are made inaccessible by use of spinner knobs.
Medications and other hazardous items were inaccessible to children. LPA did not observe any poisons in the home. The fireplace located in the living room was made inaccessible to children by a glass screen and will not be used during day care hours. The fire extinguishers, smoke detectors, and carbon monoxide detector met Community Care Licensing (CCL) regulations. Heating/cooling and ventilation was sufficient for safety and comfort. There were no stairs in the home. Safe toys and play equipment were observed. Licensee had a working telephone and the above telephone number was verified. Adequate supervision was being provided during this inspection. Capacity as specified on the license was being maintained. Staff-child ratios were maintained.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
The backyard is currently off-limits to day care children. The outdoor play area in the backyard is fenced. Licensee ensures that children in care are supervised at all times. There were no swimming pools, bodies of water, or firearms on the premises.
Continued on LIC809-C
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE: DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/23/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/23/2021 02:40 PM - It Cannot Be Edited


Created By: Theresa Marquez On 11/23/2021 at 02:04 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CALLAHAN, KEYA FAMILY CHILD CARE

FACILITY NUMBER: 153907476

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 11/23/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above for 1 infant under the age of 1 year old, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/30/2021
Plan of Correction
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Licensee is to complete the LIC9227 and place in child's file by November 30, 2021.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Susie Fanning
LICENSING EVALUATOR NAME:Theresa Marquez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/23/2021


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CALLAHAN, KEYA FAMILY CHILD CARE
FACILITY NUMBER: 153907476
VISIT DATE: 11/23/2021
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A sample of children’s records contained all emergency information specified by regulation. A review of records indicated Licensee has proof of required immunizations (Pertussis/Measles/Influenza). Licensee's Mandated Reporter Training was completed on 7/10/2021. Licensee's pediatric CPR and First Aid expires on 2/20/2023.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms, and Regulations.

Operating hours are Monday through Friday 6:30 AM to 6:00 PM.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiency was found: Child #12 (an infant) is missing in file, the required form LIC9227 Individual Infant Sleeping plan.
(see next page):

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
Exit interview conducted and report was reviewed with the Keya Callahan. A copy of Appeal Rights. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021
LIC809 (FAS) - (06/04)
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